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Frequently Asked Questions

Frequently Asked Questions are used to provide additional information and/or statutory guidance not found in State Medicaid Director Letters, State Health Official Letters, or CMCS Informational Bulletins. The different sets of FAQs as originally released can be accessed below.

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How do I delete a submission package?

Log in as State Point of Contact. Go to the Actions tab, then select "Delete Submission Package". Enter in the package ID and the SPA ID, then search for the package you wish to delete. Only the State Point of Contact can perform this function. This function is only available before a package is submitted to CMS for the first time. After that, the only option for the SPOC would be to withdraw the package.

FAQ ID:92926

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Is there a way to attach additional information or appendices to a submission package?

Yes, there are various places throughout a package to attach additional information. In many reviewable units, depending on the selections made, an opportunity to upload documents is available. Uploading a document to the Health Homes Services Reviewable Unit is required.

FAQ ID:92931

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What is a validation error within a submission package?

A validation error occurs when additional information is required for certain fields on a page. This error will be indicated by red script on the page under the section that was required. In order to avoid a validation error, enter in all required information before attempting to validate data. For many screens this will occur upon selecting a button located towards the bottom of the page to validate your entries.

FAQ ID:92936

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What reports are available to State Users?

This table indicates what reports are available to State Users. These can be found under the "Reports" tab.

Report Name Description Available For
State Agency Profile Report Overview of a State's Medicaid Plan including the prior 12 months' submission package history State Point of Contact; State Director
Submission Detail Report View details on packages by date State Editor, State Point of Contact, State Director
Submission Statistics Detail Report View all Submission Packages currently in review State Editor, State Point of Contact, State Director
Submission Summary Report Overview of submitted packages by date State Editor, State Point of Contact, State Director

FAQ ID:92941

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Once a state submits a submission package to CMS, is the content locked?

Once a state submits a submission package to CMS, they may not edit it while it is in review. The state may withdraw the submission package, but once withdrawn, the package cannot be edited or resubmitted.

CMS may open the package for revisions informally via a clarification request. Clarification questions are entered into the Correspondence Log. The CPOC can compile questions from the Submission Review Team members by accessing the Analyst Notes. Please note, that the reviews of every RU does not have to be completed in order to send a request for Clarification to the State. During a Clarification, the State will have the opportunity to edit content. After the state has responded to Clarification, the CMS Point of Contact must assign Submission Review Team members to Reviewable Units again and review the submission package again.

After requesting Clarification, CMS (specifically the CPOC) has the option to prevent package submission. This is a way for CMS to pull the package back from the Clarification request. This may be necessary as the clock continues during the Clarification period. The CMS review team may not continue their review while the package is back with the State for Clarification, therefore the CPOC should exercise caution when to sending a Clarification, knowing that review will be temporarily suspended.

Another option is after CMS Point of Contact has reviewed the submission package, he/she has the option to Request Additional Information regarding the submission package. All Reviewable Units must appear in the complete status (represented by a checkmark) by having at least one Review Team member complete the review in order to initiate RAI. RAI stops the 90 Day Clock. In this option, the State will have the opportunity to edit content.

FAQ ID:92991

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How do I access previous reports for my state?

Select the "Records" tab in the upper tool bar. Click on the Quality Measure you are working with and then search for the report you would like to view by entering the report package ID.

FAQ ID:92996

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Is there a way to attach additional information or appendices to a report?

Yes, at the end of each report there is an "Upload Documents" section that allows you to upload any relevant documents.

FAQ ID:93011

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Can states rely on the information contained in the enhanced flat files?

We believe these files have information that states can rely on. As with any transmission of data or logic process, discrepancies may arise. However, we have done quality reviews and continue to act on reports of issues as quickly as possible by investigating them and introducing systems fixes as needed. We are continuing our testing and quality assurance efforts as well. We expect that states will be doing the same on accounts transferred from states to the FFM. We will continue to rely on our daily desk officer calls and our SOTA process to follow up with states on any questions that may arise.

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FAQ ID:91906

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What action may the state take if the state believes there is another basis for excluding an individual from flat file-based enrollment based on state analysis or external information?

If the state would like to exclude individuals from enrollment based on the flat file, please reach out to CMCS to discuss the state's options. Our goal in offering this flat file option is to provide an additional avenue for enrollment and we will work with states on how they might best maximize the use of these files.

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FAQ ID:91921

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What if a state later determines that a person enrolled based on information in the flat file is not eligible for Medicaid or CHIP?

In a letter dated November 29, 2013, (see http://www.medicaid.gov/Federal-PolicyGuidance/downloads/SHO-13-008.pdf (PDF, 117.76 KB)) CMS offered states the opportunity to apply for a waiver under section 1902(e)(14)(A) of the Social Security Act to allow them to make temporary enrollment decisions based on the information included in the flat file. So, as long as states follow the procedures outlined in the guidance and other applicable rules with respect to eligibility and claiming, federal funding is available for this temporary enrollment. Individual's circumstances might change and other factors might arise that could change the outcome of the eligibility determination once the state evaluates eligibility based on the full account transfer. Federal funding is not at risk for states that follow appropriate procedures to enroll beneficiaries based on the FFM's determination or assessment of eligibility.

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FAQ ID:91926

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